Archive for February, 2019
Thursday, February 28th, 2019

Our STRATEGIC OPEN ACCESS PLAN (SOAP) is designed to clean up your group medical program using common sense and traditional American business practices. Clients who adopt our strategies will realize plan savings of 20-40% while maintaining or even improving benefits at the same time.
“Cleaning up Your Employee Health Plan”
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Thursday, February 28th, 2019

Still quoting the same 100/80/50 Dental Plans that were popular 20 years ago? Let’s surprise your client with a new and innovative dental offering.
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Thursday, February 28th, 2019

Maybe the problem with solving health care in this country centers around the apparent abundance of naysayers………………
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Thursday, February 28th, 2019

Judge, he’s a bully, manipulative, passive-aggressive and self-centered. I don’t love him anymore!
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Wednesday, February 27th, 2019

A Reference Based Pricing solution called SmartDecision. It offers RBP, bundled pricing, cost and quality information, and a concierge service to help members navigate the entire healthcare episode. Please review our flyer to learn more about this truly unique program. Click here to download.
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Wednesday, February 27th, 2019

Medicare-for-all would move every American onto one government insurer in two years, while providing everyone with medical, vision, dental and long-term care at no cost………….
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Wednesday, February 27th, 2019
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Tuesday, February 26th, 2019
In Florida, Drug Re-Importation from Canada Finds New Champions, Old Snags
“Florida is joining the growing ranks of states that, squeezed by climbing drug prices, are eyeing the Canadian fix…. Legislation has been advanced this year in about a dozen states that would advance wholesale drug importation programs … While statehouses may be abuzz, in Washington, national politics impedes feasibility. And skeptics question how much relief these initiatives could actually provide.”
Kaiser Health News
Departments Ask for Advice from Health Plan Sponsors: Preserving ‘Grandfathered Status’ Under the ACA
“The specific questions include: [1] Do any of the requirements for maintaining grandfathered status create particular challenges, and how could these requirements be modified to reduce these challenges? [2] Why do plan sponsors choose to retain grandfathered status? [3] What are the costs and benefits that plan sponsors consider in deciding whether to retain grandfathered status? [4] Is preserving grandfathered status important to plan participants? [5] What changes in benefits typically trigger a loss of grandfathered status?”
Segal Consulting
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Tuesday, February 26th, 2019

Once upon a time, health benefits were just that – “benefits.” Now, it’s assumed health insurance is included in an employment package, and what was once a benefit is now an entitlement…..
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Monday, February 25th, 2019

Mugshot photo of Melissa Welch-Latronica, 30, of LaPorte. (Porter County Sheriff’s Dept.)
Single mother goes from traffic stop to bench warrant to jail over unpaid medical bill: ‘It just isn’t right’
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Friday, February 22nd, 2019

Price of Drugs Is Too Damn High!
“This ruling blows the insulin racket wide open,’’ said Steve Berman, a plaintiffs’ lawyer who is one of the leaders of the potential class-action case. The ruling “clears the way for us to begin obtaining discovery from the manufacturers and PBMs so we can shine the light on exactly what has driven insulin prices sky-high,’’ he said.
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Friday, February 22nd, 2019

“Direct primary care (DCP) — a fee-based model that gives individuals unlimited access to a primary care doctor for anywhere between $60 to $150 a month, without insurance being billed — is the “future of healthcare….”
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Thursday, February 21st, 2019

Last month, we received our license to sell Association Health Plans (AHPs) to medical groups in Texas through the Oklahoma State Medical Association (OSMA). They have a proven track record of providing significant savings to their members and offer a broad range of health plans.
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Thursday, February 21st, 2019
Just like 4.3 million other Texans, they have zero health coverage. They simply cannot afford health insurance. “We don’t have health insurance because it’s just outrageous. We have to choose food or clothing over health insurance, and food and clothing are just going to come first,” Kevin Doetticher said.
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Wednesday, February 20th, 2019
Industry wide, transparency is not the standard. ProPublica sent a list of questions to 10 of the largest broker agencies, some worth $1 billion or more, including Marsh & McLennan, Aon and Willis Towers Watson, asking if they took bonuses and commissions from insurance companies, and whether they disclosed them to their clients. Four firms declined to answer; the others never responded despite repeated requests.
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Tuesday, February 19th, 2019

Brian Klepper
“Renegade PCPs long for independent practices where their patient care decisions are not so influenced by their employers’ interests……………….By recapturing control of care and cost, they also are re-establishing primary care’s primacy within health care……………..”
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Monday, February 18th, 2019

“In 60 seconds, this CEO explains why healthcare has blocked many manufacturing jobs from coming back to the U.S.” – Dave Chase on Linkedin………………..
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Sunday, February 17th, 2019
The state of North Carolina has adopted Reference Based Pricing for their state employee benefit program to become effective in 2020. The reference price will be pegged at 177% of Medicare. That has caused an uproar with the state’s hospitals and they are fighting back hard.
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Sunday, February 17th, 2019

By Molly Mulebriar
McAllen Independent School District in deep South Texas is set to interview the top three finalist for the district’s insurance consultant position this week. MISD employee benefit program is self-insured and administered by Blue Cross & Blue Shield.
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Saturday, February 16th, 2019

“It’s an intriguing way to lower costs for both physicians and health plans, and it could reduce premiums for patients. It also could enable doctors to wrestle more contract-negotiating leverage out of the hands of the market’s dominant health plans ― and in some cases, contracting with them might not even be necessary.”
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Saturday, February 16th, 2019

“We are taking that wasted money and artificially inflating the cost of health care to the point that nobody can afford it without government continuing the death spiral of spending, monopolizing, and price inflation.”
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Thursday, February 14th, 2019

In this video, Dr. Eric Bricker Explains Reference-Based Pricing.
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Thursday, February 14th, 2019

Dr. Eric Bricker Explains 3 Reasons for Having a PCP: 1) Screening, 2) Same-Day / Next-Day Appointments and 3) After-Hours Call-In Access.
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Tuesday, February 12th, 2019
In contrast to deductibles, where the patient pays the “first dollar” of medical expenses, under RBP, the patient is responsible for the “last dollar.”
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Tuesday, February 12th, 2019
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Monday, February 11th, 2019

Liberty Mutual has agreed to pay the Diocese of Duluth US$6.5 million under a recent settlement agreement over litigation of insurance coverage for child sexual abuse damages………..
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Sunday, February 10th, 2019

Greenlight Re Innovations, part of specialist property and casualty insurer Greenlight Capital Re, has announced an investment in Sana Benefits, a Texas-based third-party administrator (TPA) focused on the self-insured health market……………...
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Sunday, February 10th, 2019

Four men and seven companies have been charged in connection with a $1 billion healthcare scam, according to the Department of Justice………………….
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Sunday, February 10th, 2019

AccuRisk Solutions LLC is a Chicago-based Managing General Underwriter focused on providing its producers with innovative insurance products and outstanding customer service.
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Sunday, February 10th, 2019

“It’s cheaper for us to pay for the drug down there, send them down there and then give them $500….”
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Sunday, February 10th, 2019

Japan Post would like to expand Aflac’s cancer insurance products sold at post office counters…..
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Friday, February 8th, 2019

Kratom is a miracle cure for everything from opioid addiction to anxiety……..
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Friday, February 8th, 2019
I’ve been asked many times if there was one thing, one moment, that led me to leave my job at a big health insurance corporation. Yes, there was, and it occurred five days before Christmas in 2007. That was when a beautiful 17-year-old girl named Nataline Sarkisyan passed away, days after the company I worked for refused to pay for a liver transplant that her doctors believed would save her life. A few days after Nataline’s death, I turned in my notice.
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Friday, February 8th, 2019

If your’re in HR and believe in climate change this article is for you. You may want to consider offering your employees energy-free light bulbs and mandate car pooling………….
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Friday, February 8th, 2019

Molly Fetzer
Self-funded school district overrides TPA’s (Anthem) decision to deny coverage and authorizes doctor ordered treatment plan for stage 4 cancer member………………….
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Thursday, February 7th, 2019

Putting dollars in front of saving lives……………………..?
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Wednesday, February 6th, 2019

Respected industry leader passes………………………
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Wednesday, February 6th, 2019

“I’m 67, so I could give a shit,” she says. “What are they going to do, fire me? I’m packin’ a Medicare card.” – Marilyn Bartlett
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Tuesday, February 5th, 2019

Colorado on Thursday joined a growing number of states that want to cut certain prescription drug prices by importing licensed drugs from Canada………………..
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Tuesday, February 5th, 2019

Bernie Discovers Self At Early Age
Senator Sanders asks why drug, once free, now costs $375,000,000.00…………..
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Tuesday, February 5th, 2019

The HRA’s Are Coming!
Expands the use of HRAs to allow for the purchase of individual health insurance coverage…..
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Monday, February 4th, 2019
Hawaii considers ban on cigarette sales except for centenarians…………………..
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Sunday, February 3rd, 2019

Health insurer’s purchase of Express Scripts is looking like even more of a blunder……..
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Sunday, February 3rd, 2019
With steady growth in the last four decades, self-funded plans are now the most common type of health plan that workers are enrolled in across the United States. Various sources put this number at nearly 70% and climbing. Nearly all self-funded employee benefit plans are managed through a third party administrator (TPA) firm, an independent organization that assists with overall plan operations, benefit coordination and claims processing.
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